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A Gap in Neuropsychiatric Knowledge. 神经精神病学知识的空白。
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引用次数: 0
Reviews and Notices of Books 书评和图书通知
Pub Date : 1937-01-01 DOI: 10.1136/jnnp.s1-17.67.283
THIE aimii of the writer of this book has been to present to his readers, chiefly perhaps to students and members of the profession, an account of the nature and causes of personality disorders. What might be termed the anatomy and physiology of personality are first discussed; that is to say, its relation to constitution is examined, and the effects on its working of heredity and environment. Therefore the author is concerned with the debatable ground, the no-man's-land (or should we say every-man's-land ?) of the marches between the physiological and the psychological. Mental mechanismis, current methods of examination and some clinical syndromes are discussed in a later section. In his studies the author has sought to follow objective lines, is temperate in his conclusions, and has produced a volume which will not alienate the neurologist by its neglect of the nervous system or disappoint the psychopathologist by under-emphasis of the side of the subject that appeals to him.
本书作者的目的是向他的读者,也许主要是学生和专业人士,介绍人格障碍的性质和原因。首先讨论的是人格的解剖学和生理学;也就是说,考察了其与体质的关系,以及遗传和环境对其工作的影响。因此,作者关注的是一个有争议的领域,即生理和心理之间的无人区(或者我们应该说是每个人的领地?)。心理机制,目前的检查方法和一些临床证候将在后面的部分讨论。在他的研究中,作者试图遵循客观的路线,在他的结论中是有节制的,并且已经产生了一卷不会因其对神经系统的忽视而疏远神经学家或因其对吸引他的主题的强调不足而失望的精神病理学家。
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引用次数: 0
Associated Facial, Vocal and Respiratory Components of Emotional Expression: An Experimental Study. 情绪表达的相关面部、声音和呼吸成分:一项实验研究。
Pub Date : 1937-01-01 DOI: 10.1136/jnnp.s1-17.67.241
H W Magoun, D Atlas, E H Ingersoll, S W Ranson
AMONG the topics which Kinnier Wilson 1 has selected as representing some modern problems in neurology is that presented by the clinical picture of dissociation of the voluntary and emotional innervation of the facial muscles. It has long been known that patients suffering a paralysis of volitional movement of the facial musculature, as a result of supranuclear cortical or capsular lesions, may retain an activity of these muscles in the expression of emotion. Conversely, cases have been reported in which voluntary activation of the facial muscles has been unimpaired, while emotional excitement failed to produce the appropriate facial expression. In his review of this subject, Kinnier Wilson 2 has suggested in explanation that the voluntary and emotional innervations of the facial nuclei are effected by different systems within the brain. Enlarging upon this suggestion, Wilson has postulated a brainstem mechanism which subserves the synkinesis of the facial, vocal and respiratory activity observed in emotional behaviour. Further elucidation has been provided by Bard 3 in a consideration of facial and vocal activity from the point of view of his 4' 5 recent studies of the brainstem mechanisms involved in the expression of emotion. Our interest in this problem has developed from a series of investigations of these brainstem mechanisms (Ranson et al.6-13), in the course of which we have repeatedly observed coordinated facial and vocal responses obtained as specific reactions to stimulation of localized areas within the brainstem of experimental animals. It seemed desirable to make a special study of these effects, and we wish now to report the results of an investigation of such responses obtained from systematic electrical stimulation of the brainstem of the lightly anaesthetized cat and monkey and of the acutely decerebrate cat. METHODS
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引用次数: 197
The Diagnosis of Chronic Subdural HæMatoma of Traumatic Origin. 外伤性慢性硬膜下h æ瘤的诊断。
Pub Date : 1937-01-01 DOI: 10.1136/jnnp.s1-17.67.262
G S Hall
WITHrI recenIt tillle there has been a considerable increase of the literature on chronic sujbduiral hilematoma. The personal observation of sev.eral cases recently withlin the spaee of a year is evidence of its clinical importance and is perhaps sufficient justification for redrawing attention to this not uncommon condition. Examiniatioii of the literature suggests that certain aspects of the synmptomatology are not receiving the recognition they deserve; the cases helrc recor(led are important in that they illustrate those aspects to which it is desired to draw attention. Failure to bear in mind the possibility of the condition may result not only in valuable time being lost before the correct treatment is instituted, but may prove fatal to the patient. No useful purpose is served by distinguishing between the more acute and the more chronic types of subdural hwmatoma. There is, however, a type of case in which severe and sometimes rapidly fatal symptoms of intracranial heemorrhage develop immediately after trauma. Operation or autopsy show%s that the lesion in some of these cases is an acute subdural h,emorrhage. In the author's opiniioIn such cases should iiot be regarded as examples of chronic subdural hxmatoma. There is sometimes a tendeicv to conlfuse these two states; it is felt that case 6 reported by Kaplan is essentially an example of an acute subdural hoemorrhage. In chronic subdural hwmatoma the latent interval which elapses between the occurrence of trauma and the onset of symptoms varies considerably, and in those cases where symptoms develop immediately after trauma the initial lesion is presumablv a small subdural hemorrhage which passes unrecognized as such and gradually develops into a true hoimatoma; in cases where the latent period is long, it seems probable that the slowly leaking blood collects and does not give rise to symptoms until after a definite hematoma is formed. It is proposed in this paper to give a clinical description of the cases observed anid to linmit subsequent discussion to a conisideration of the occurrence of raised intracranial pressure.
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引用次数: 0
A Gap in Neuropsychiatric Knowledge 神经精神病学知识的空白
Pub Date : 1937-01-01 DOI: 10.1136/jnnp.s1-17.67.270
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引用次数: 0
The Cerebral Circulation: Some New Points in its Anatomy, Physiology and Pathology. 脑循环:解剖学、生理学和病理学的新观点。
Pub Date : 1937-01-01 DOI: 10.1136/jnnp.s1-17.67.193
T J Putnam
IT is not many years since the current teaching in regard to the cerebral circulation might be summed up in the anatomical doctrine that the vessels were ' end-arteries,' without anastomoses distal to the circle of Willis; the physiological doctrine that the cerebral vessels were without vasomotor supply, and changed their calibre only passively as a result of changes in the systemic blood pressure; and the pathological doctrine that thrombosis in the brain caused softening, and rupture of a vessel caused apoplexy. During the last two decades, a large number of investigators have approached the subject afresh along many different avenues, and have established a body of data which places the whole matter in an entirely new light. To review all of the work which has been done during this period would require far more than an evening's lecture, but although it is obvious that additional facts mean additional complications, certain broad principles stand out which have won general acceptance, and it is these that I should like to present here. Not only have the structure and function of the cerebral circulation a great theoretical importance, but they possess a considerable practical importance for diagnosis and treatment as well, and promise even more for the future.
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引用次数: 7
An Investigation of the Absorption of Ultraviolet Light by Cerebrospinal Fluid in Various Disease States. 不同疾病状态脑脊液对紫外光吸收的研究。
Pub Date : 1937-01-01 DOI: 10.1136/jnnp.s1-17.67.213
E F Skinner
THE examination of cerebrospinal fluid in various diseased states has become a matter of routine investigation and at times yields information of great value in particular cases-for instance, the presence of a cellular content of over 3 per c.mm. leads to a suspicion of some infective process involving the central nervous system, and the preponderance of a mononuclear type of cell suggests the probability of such infection being of a granulomatous nature, syphilis or tuberculosis. Further, an increase in the protein content of the fluid is indicative of chronic infection, while reduction in the amount of sodium chloride present below 06 per cent. is almost pathognomonic of tuberculous meningitis. Of the more recent tests used in the examination of cerebrospinal fluid the precipitation of gold from a colloidal suspension of gold chloride is of peculiar interest. It appears to be an extremely sensitive test and to possess a definite diagnostic value. It is not necessary to refer in detail to this test; suffice it to say that it appears to depend on the upset of the balance of electric charges on the colloid particles in the gold solution with consequent precipitation of metallic gold. Lange's work at first seemed to suggest that in this method was to be found a specific test for neurosyphilis, since the highly albuminous fluids of general paralysis and tabes caused precipitation of gold in a manner which could be expressed as a simple curve. Other workers confirmed Lange's observations, but as the test became more widely recognized it was soon found that cerebrospinal fluids from cases other than neurosyphilis caused a similar precipitation, notably disseminated sclerosis. The test lost its specificity as a touchstone for neurosyphilis, but none the less the curves obtained are so characteristic that in association with other tests it is possible to say with considerable certainty whether a particular type of curve is caused by a fluid from a case of neurosyphilis or of disseminated sclerosis. PERSONAL INVESTIGATIONS
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引用次数: 1
Bilateral Atrophic Lobar Sclerosis following Thrombosis of the Superior Longitudinal Sinus. 上纵窦血栓形成后的双侧萎缩性大叶硬化。
Pub Date : 1936-10-01 DOI: 10.1136/jnnp.s1-17.66.135
R M Norman
IsN the category of atrophic lobar sclerosis it is customary to group a number of degenerative affections of the cerebral cortex having a differing and often obscure pathogenesis but a comparatively uniform morphology. Macroscopically, the cortex in these cases shows a shrinkage of the gyri with a corresponding widening of the intervening sulci. Apart from the changes produced by these distorting factors, the general convolutional patterning of the hemispheres is normal, so that usually it is possible to distinguish by naked-eye inspection this type of abnormality from true microgyria of developmental origin. The name ' ulegyria ' is often used to describe this condition of atrophy of the convolutions. Microscopically, it is apparent that the neurones of the affected gyri have degenerated to a greater or less degree and that an extravagant proliferation of the fibrous neuroglia is present in those areas where neuronal destruction has been most complete. This gliosis tends to vary according to the time of onset of the primary cortical lesion, being densest and most widespread when the disease has started during foetal or infantile life and being less pronounced in the more mature brains.15 In the latter class of case there is evidence both from the clinical and pathological standpoints that a progressive degeneration of the cortex may occur. In this type of progressive cortical atrophy the lesions are essentially laminar in distribution and affect chiefly the third or pyramidal cell-layer. As Hallevorden 8 has pointed out, the similarity of the histopathological findings in cases of lobar sclerosis is no proof of an uniform aetiology. This observation is particularly pertinent when an attempt is being made to evaluate the part played by birth injury in the actiology of a given case. Although the extensive investigations of Schwartz 13 have shown that atrophic sclerosis may follow multiple small intracerebral haemorrhages or softenings, it is clearly unjustifiable to classify all cases of lobar sclerosis with a clinical history of ' difficult labour 'as the result of vascular lesions sustained during birth. Moreover, the precise mechanism by which these haemorrhages are produced is not yet fully understood. According to Schwartz, they 1 3.1
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引用次数: 8
Psychopathology 精神病理学
Pub Date : 1936-10-01 DOI: 10.1136/jnnp.s1-17.66.189
MYERSON has established for himself the following guiding principles: first, that wherever a psychosis is mainly of constitutional origin, and where medical science is yet unable to find any direct environmental relationship, he is reluctant to state that any environmental event is a probable exciting or precipitating or aggravating cause. If, however, an environmental event occurs which is of serious nature, such as severe trauma, or of great emotional significance, and if it can be shown that the psychosis occurred within a very short period, he is willing to admit some relationship. This is true, however,. mainly of manic-depressive psychosis. He is willing to admit a psychological event as a probable cause for the occurrence of this psychosis. Manicdepressive is mainly an affective psychosis. It is therefore logical to assume that a serious emotional situation may, if immediately followed by a manicdepressive state, be a precipitating or aggravating cause. He is unwilling to admit that there is any reason to assume that this is a factor in the precipitation of dementia prtecox, largely because the schizophrenic state is not, as. far as we know, emotional in origin, and because the personality alteration is of more profound nature than the change which takes place in manicdepressive psychosis. C. S. R.
迈尔森为自己确立了以下指导原则:第一,只要精神病主要是由体质引起的,而且医学还无法找到任何直接的环境关系,他就不愿意说任何环境事件都可能是引起兴奋、加速或加重的原因。然而,如果发生了严重的环境事件,如严重的创伤,或具有重大的情感意义,如果可以证明精神病是在很短的时间内发生的,他愿意承认一些关系。然而,这是真的。主要是躁郁型精神病。他愿意承认某种心理事件可能是导致这种精神病发生的原因。躁郁主要是一种情感性精神病。因此,假设一个严重的情绪状况,如果紧随其后的是一种严重的抑郁状态,可能是一个促成或加重的原因,这是合乎逻辑的。他不愿意承认有任何理由认为这是痴呆沉淀的一个因素,很大程度上是因为精神分裂症状态不是。据我们所知,是源于情感,因为人格的改变比发生在躁郁型精神病中的改变具有更深刻的本质。c.s.r。
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引用次数: 24
Needed Reforms in Psychiatry and Neurology. 精神病学和神经病学需要改革。
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引用次数: 0
期刊
Journal of Neurology and Psychopathology
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